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Dying In the ICU After Surgery for Ovarian Cancer and Chemo for Lymphoma

Chinese New Year (January/February 2009) was a time of celebration. Wan, a 30-year-old, married female with a 2-year-old child, visited her mother in Kedah. She enjoyed the food that mom cooked for that day. Wan was OK then – healthy as mom’s eyes can see. But after the meal, she felt some “wind” in her stomach. Mom suggested that she consulted a doctor. She did not get to see any doctor until 2 weeks later. Unexpected, this was the beginning of a tragic road to her quick death?

Wan’s mother and auntie came to seek our help on the morning of 25 March 2009. This was what had happened.

Wan went to see a doctor in a private hospital. She was told that she had ovarian cancer and needed an operation. Wan then moved on to another private hospital believing that another doctor was better able to handle her case. On 16 February 2009, Wan underwent an operation to remove her so-called cancer in the ovary. It was a total hysterectomy. But Wan’s condition did not improve in spite of the surgery. Her stomach was still bloated. Later she became breathless. While still in the hospital for a week, her lungs were filled with fluid. The doctor tapped out the fluid and she was able to breath.

Wan was still not well. She felt heaty. Wan was referred to an oncologist of the hospital for subsequent management. This doctor said Wan’s problem was actually due to lymphoma and the primary was not the ovary. The doctor also warned that Wan must undergo chemotherapy immediately. There would be no time to wait because the cancer was aggressive and was very serious.

On Monday, 2 March 2009, Wan was started on chemotherapy. The next day (Tuesday) she was alright. However, in the early morning (about 2.30 a.m.) of Wednesday, 4 March 2009, Wan started to have pains in her abdomen. The nurse gave her an injection for gastric. Later, the pains became unbearable and she was given a pain killer injection. On the morning of Wednesday, Wan started to have diarrhea. Later she had a fit, ground her teeth, became breathless and at one time her heart stopped beating. At 10 a.m. of Wednesday she was admitted into the ICU. Her face and hands were swollen. She was given oxygen and the doctor induced her into a coma and she became unconscious. On Saturday, 21 March her lungs had “bubbles” and she could not breathe. Her doctor had to fit tubes on both side of her chest to drain fluid out.

So from 2 March until 25 March 2009, Wan was in the ICU struggling to stay alive.

Just before Wan’s mother and aunty came to see us, they were told by the doctor that Wan’s chance of survival was very minimal. The family can expect her to die any time.

See the video and read the transcript of our conversation.

Mother: She was admitted on Sunday. On Monday they operated on her. It was a total hysterectomy. However, her tummy was still big after the operation and she was breathless. On checking they found there was fluid in her lungs. The fluid was drained. She felt better after that. But she always felt hot. It is not a fever. The air-conditioner was set at 10 degrees and she would still be perspiring. On further checking, they said it is lymphoma.

Chris: How long was she in the hospital? Has she gone home?

M: No, she hasn’t gone home at all. She is still in hospital. It’s been more than a month now. She was there since February.

Aunty: Since the operation, she hasn’t gone home. After her lung problem, she was referred to another doctor.

C: After draining the fluid from the lungs, she was okay?

M & A: Yes

C: Why was she still in hospital?

A: Because they wanted to give her chemo.

C: She was not allowed to go home first?

A: They say cannot wait. It is a very aggressive type. It is already very serious. Chemo must be done immediately.

C: When was the chemo done?

A: Only once, on Monday.

M: After that she was alright. She was alright on Tuesday. But at night, early on Wednesday morning around 2:30 a.m., she complained of stomach pains until daybreak. She was given injections for gastric, as well as a pain killer. She had diarrhea. Her stools were very dark. She had diarrhea again from 7.00 am to 8.00 am. She had pains in her stomach again. She asked me to get the doctor to check her quickly as she could not stand the pains anymore. She was struggling in bed, kicking the bed very hard. She was biting and grinding her teeth. It looked as if she was having a fit.

When the doctor came, I explained what had happened (the events that took place throughout the night and morning). He did a routine check on her and left. He did not answer my questions or say anything. He just left.

I was waiting for some pain killer to be administered, but later when a nurse passed by, I asked about the pain killer and she explained that the pain killer had already been given the night before. So, they could not give her another pain injection now. Then she just went away.

I then requested for my daughter to be cleaned up. And as the nurse was cleaning her, she started to feel breathless. Then suddenly her head turned to one side, and a little foamy saliva started to drool out of her mouth. I screamed and a sister came in to adjust her drip and a couple of things. Actually, her heart stopped beating for a while.

C: Her heart stopped?

M: Yes, it did. They revived her. (by banging, etc – we were not allowed to see). An hour later, about 10:00 a.m. she was brought to the ICU. She is there until today. She is still there – unconscious. When they brought her in, her face was already swollen. The neck, shoulder and arms were swollen too. She looked very different. The swelling subsided on the third day. And now, she looked very thin.

C: How is she now?

A: Still unconscious. Never wake up yet. It is already about 20 days.

M: Cannot let her wake up. She is given oxygen. When the oxygen is removed, her pressure dropped. They kept putting her to sleep. We’ve never spoken to her since she went in.

A: I spoke to the doctor. He said she cannot let her wake up as the oxygen pressure is very high. She may not be able to take the high pressure. That is why they made sure she is totally unconscious.

M: Last Saturday, they drained more fluid from her lungs. It looks like there is very little chance of saving her. This morning, the doctor told us to be prepared. The doctor said her condition is very serious and the cancer will spread very fast.

A: I was wondering why the chemo must be done when she was still so weak.

M: Actually after the operation, she was alright. She could watch television and was normal. The nurse asked her to get up and walk and she got up and walked – just a little breathless at first (Mother cried).

C: If it is possible, you can start by giving her Capsule A and Juvo (food supplement made from a variety of beans). If after 2 or 3 days, there is some progress, then we can slowly add more herbs. It is a very difficult situation. What is going to happen the next few days no one can tell. But we will try our best.

A: They already conceded they could not do anything else anymore for her.

Comments

The total cost of her treatment as of 24 March 2009 is RM 194,730.13. Indeed it is very expensive to die in this modern day scientific age.

Can any body answer this question: Her mother told us: When the doctor came, I explained what had happened (the events that took place throughout the night and morning). He did a routine check on her and left. He did not answer my questions or say anything. He just left. Why did the doctor just left without answering her question? In a similar case, Sam and his wife were coerced into consenting to a liver operation on Sam. The surgeon even hugged Sam’s wife and assured her everything was going to be alright. At the same time warned that he must be operated on immediately. But after the cancer had recurred, the surgeon became “hostile” and did not even want to talk to them. Why is this so?

There is an Arab saying: Haste is from the Devil. Wan did not even have a chance to recuperate properly from her surgery. She was immediately asked to go for chemotherapy. She was told the cancer was aggressive. How true is this? Before she came into the hospital she was alright. What made the cancer aggressive? Or is this a spin – a veiled threat to instill fear into patients so that they would agree to chemotherapy?

The doctor’s medical report indicated that Wan required an emergency dialysis. Her renal function had reversed. What had her kidney failed? What could be the cause? The toxic chemo-drugs? Wan did not have such a problem before.